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� <br />Permit No. ..._ �.� �..`-- <br />P <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT. WASH. <br />The Undersigned / "'C <br />r <br />Hereby applies for permission to <br />At the following location Z <br />SKETCH <br />Mom to be done) <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims for damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove same upon notice from the City and to replace oil <br />public property damaged thereby. <br />R„s (a�o.. Cpy,,',. <br />EM, <br />Inspector's Wnature <br />/lrl-7- 2- /(L% <br />Date <br />W <br />proved By "— - <br />Ocydber 23 q(-Aq' -- <br />Date 4pp'�ved <br />Variance Required <br />Yes <br />No.. _._ _.. .... <br />Signature of Applicant <br />Address <br />Telephone Number <br />Date <br />Fee <br />DEFT. APPROVALS <br />Engineers f <br />6 , a "— <br />Water <br />Street <br />---- __ -- <br />Cormr^^ir��ionc_ <br />— - <br />